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Brian Muir, PhD
Highly-inquisitive team-leader with 11+ years of experience employing machine learning and statistics in the healthcare industry and in computational biology. Direct the forecasting of $10+ billion in pharmacy and medical claim expenses using advanced predictive models in R for Centene Corporation’s (Fortune 500) marketplace insurance LOB.
Education
University of California Riverside
Ph.D. in Evolution, Ecology & Organismal Biology
Riverside, CA
2016 - 2010
Boston College
B.S. in Biology, Psychology (Double Major)
Chestnut Hill, MA
2010 - 2006
Professional Experience
Director - Marketplace Forecasting
Centene Corporation / Actuarial Services
Chicago, IL
Current - Jul, 2018
- Direct the development, implementation, and presentation of the financial forecast for medical expenses expenses across 26 state products using mixed-models regression.
- Lead a team of six actuaries and data analysts working on a wide range of analytics projects encompassing: interactive claims dashboards using Rshiny and RMarkdown, advanced forecasting methods, SQL database creation and maintenance, and ad-hoc deep dive analyses for multiple business partners across Actuarial, Finance, Sales, Product, Policy, Medical Management, Pharmacy, and Marketing.
- Present findings to leadership on member-segmented variances to forecast, financial impacts of COVID cost and deferral of services, and deep-dives into claims trends during monthly CFO financial briefings.
- Developed a member-level gross margin database detailing revenue and expense components across 40 targetable member characteristics that integrates disparate data sources using SQL/R. Deployed overlaying drill-down dashboard in RSConnect used widely across departments to identify risks and opportunities for member-segmented business actions.
- Identified an $8M annual initiative to improve on risk adjustment code capture of Hemophilia that we continue to support with outreach targets via an in-production Shiny Dashboard.
- Created stratified med-management model based on interacting the two dimensions of utilization and health status to highlight top conditions, disease management status/acceptance, risk score, risk adjustment code capture opportunity, claim costs and demographics by segment to identify optimal cohorts for med management programs.
Data Scientist I
Centene Corporation / Actuarial Services
Chicago, IL
Jul 2018- Sep 2016
- Built and implemented a novel claims completion model using regression to estimate incurred but not reported expenses prior to month end; an advance over traditional methods to accelerate preparation of financial reporting and commentary.
- Developed a claims outlier detection model by Episode Treatment Group to direct investigations into abnormal claim areas each month.
- Designed primary care auto-assignment algorithm to optimally assign members to high-quality, low-cost providers.
- Devised Rx Trends and Top Conditions interactive RMarkdown dashboards to highlight emerging trends in Rx utilization; present findings monthly during Rx Governance Committee meetings.
Research Experience
Graduate Research Assistant
University of California Riverside
Riverside, CA
2010 - 2016
- Analyzed large gene expression datasets with R (Bioconductor) using non-parametric statistical models.
- Performed statistical tests of codon evolution in cancer gene-sequence alignments using maximum likelihood models.
- Designed and directed multi-year longitudinal experimental evolution study on fruit flies overseeing 2 – 6 undergraduate volunteer research assistants per quarter. Employed advanced experimental design statistics.
- Taught 18 quarters of upper and lower division biology courses with up to 150 students per week. Mentored 2 – 6 undergraduate volunteer research assistants per quarter.
Publications and Presentations
The expression of tumour suppressors and proto-oncogenes in tissues susceptible to their hereditary cancers.
Muir, B. & Nunney, L. British journal of cancer, 113(2), 345-353.
N/A
2015
Peto’s paradox and the hallmarks of cancer: constructing an evolutionary framework for understanding the incidence of cancer.
Nunney, L. & Muir, B. Phil. Trans. R. Soc. B, 370(1673), 20150161.
N/A
2015
Presentations
- International Biannual Evolution and Cancer Conference - Lightning Talk & Poster | 2015
- Evolution Conference - Talk | 2014
Exams
Society of Actuaries Exams
- PA - Predictive Analytics | Jun 2019
- SRM - Statistics for Risk Modeling | Jan 2019
- P - Probability | Sep 2018